Action - 360 Degree Feedback Survey Sample #14

360 Feedback Survey

Instructions

Our company is administering a new web-based survey tool which is designed to gather broad feedback as it relates to core competencies and role responsibilities that are important for the on-going success of our organization. The Leadership Team Members have agreed to participate and are seeking your feedback.

You have been chosen to offer feedback for the manager mentioned earlier. Your input plays a crucial role in 's leadership development journey. This tool aims to collect comprehensive feedback on core competencies and responsibilities that are vital for our organization's continued success. Your feedback will be combined with others to ensure your anonymity.

In responding to the assessment form, please think about your experiences working with this individual during the last twelve (12) months. Your responses will be merged with other people's feedback and presented to guide them in their on-going development. Comments will be shared anonymously, as written, with the manager, unless you indicate otherwise.

You are only being asked to rate 8 competencies. Each competency will have a variety of statements that are grouped by 4 Performance Levels. Click on the level that best describes this individual.

Please ensure that your submission is made between .

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Action	Needs Improvement	Could Benefit from Development	Performs as Expected	Is a Role Model for Others	Don't Know
Completes challenging projects successfully despite setbacks.
Avoids "Analysis Paralysis" through action.
Motivates & supports others to gain skills
Persists in work despite obstacles encountered.
Takes on additional responsibilities outside of the job description to help the team succeed.
Ensures that the team's tasks align with its overall objectives.
Initiates projects or tasks that have a positive impact on the team.
Gets the job done.
Creates opportunities and then takes advantage of them.
If [Participant Name] were to make improvements in Action, what are your suggestions for how he/she can improve this?
Feedback	Needs Improvement	Could Benefit from Development	Performs as Expected	Is a Role Model for Others	Don't Know
Actively seeks feedback from others.
Open to the suggestions of others.
Shares past experiences with others as learning opportunities.
Is easy to approach with ideas and opinions.
Accepts the views of others.
Seeks feedback to enhance performance.
Asks others for their ideas and opinions.
Is visible and approachable.
Considers other's opinion and suggestions.
If [Participant Name] were to make improvements in Feedback, what are your suggestions for how he/she can improve this?
Establishing Focus/Direction	Needs Improvement	Could Benefit from Development	Performs as Expected	Is a Role Model for Others	Don't Know
Maintains self-control when personally criticized.
Maintains focus when handling several problems or tasks simultaneously.
Makes sure that employees understand and identify with the team's mission.
Helps guide employees with prioritizing tasks.
Functions well under stress, deadlines, and/or significant workloads.
Excellent at managing time.
Stays focused even when under pressure and stress.
Aligns the department's goals with the goals of the organization.
Makes sure that employees understand how their work relates to organizational goals.
If [Participant Name] were to make improvements in Establishing Focus/Direction, what are your suggestions for how he/she can improve this?
Administrative Skill	Needs Improvement	Could Benefit from Development	Performs as Expected	Is a Role Model for Others	Don't Know
Implements and uses performance measures.
Completes reports on-time.
Takes responsibility for decisions.
High attention to detail.
Enthusiastic about taking on challenging projects.
Able to develop, justify and present a budget.
Accurately implements contract provisions.
Has strong technical/computer skills.
Strong organizational skills to keep the workspace and department in order
If [Participant Name] were to make improvements in Administrative Skill, what are your suggestions for how he/she can improve this?
Juggling Multiple Responsibilities	Needs Improvement	Could Benefit from Development	Performs as Expected	Is a Role Model for Others	Don't Know
Plans and organizes continuously while performing all other responsibilities and activities.
Keeps track of multiple assignments and deadlines.
Switches attention to more urgent tasks when necessary.
Assigns tasks based on skills of team members.
Spends the most time and effort on critical tasks first.
Coordinates the work of a team by assigning tasks to other team members.
Avoids bottlenecks in progress by assigning multiple individuals to critical tasks.
Manages impact of increased traffic flow and freight receipt by detailed planning of controllables and by anticipating and reacting positively to uncontrollables.
Prioritizes tasks for efficiency.
If [Participant Name] were to make improvements in Juggling Multiple Responsibilities, what are your suggestions for how he/she can improve this?
Safety	Needs Improvement	Could Benefit from Development	Performs as Expected	Is a Role Model for Others	Don't Know
Performs work safely.
Identifies predictable hazards in the workplace.
Participates in safety training as applicable.
Supports safety programs and procedures.
Develops a culture of safety.
Is aware of OSHA safety guidelines.
Is not afraid to question a potential safety issue observed in the workplace.
Works to implement corrective safety measures.
Develops a sustainable safety culture.
If [Participant Name] were to make improvements in Safety, what are your suggestions for how he/she can improve this?
Collaboration	Needs Improvement	Could Benefit from Development	Performs as Expected	Is a Role Model for Others	Don't Know
Respects other group/team members.
Allows various stakeholders to contribute their expertise to the solution of a problem.
Builds an environment of trust and respect to encourage risk-taking, innovation, and sharing of ideas.
Effectively works with others to create solutions to problems.
Equip the team with the right tools and technologies to facilitate collaboration.
Respectful of others in group discussions.
Collaborates across departmental boundaries and finds common ground with a wide range of stakeholders.
Promotes a culture of collaboration rather than rivalry.
Uses effective strategies to re-engage team members and secure their commitment to the business's common good.
If [Participant Name] were to make improvements in Collaboration, what are your suggestions for how he/she can improve this?
Business Acumen	Needs Improvement	Could Benefit from Development	Performs as Expected	Is a Role Model for Others	Don't Know
Creates robust talent development programs through the identification of key skills gaps and future needs ensuring the company is able to meet its mission and vision.
Able to correctly assess current/estimated valuations.
Evaluates risks in terms of their business impact and likelihood of occurrence.
Creates a risk management strategy to meet the business needs of the organization.
Thoroughly understands the business needs of the customer.
Is up-to-date with regulatory guidelines and policies.
Understands how strategic decisions impact constituents within the Company.
Anticipates the consequences to the business of different potential risk events.
Understands impacts of domestic & global market events & issues.
If [Participant Name] were to make improvements in Business Acumen, what are your suggestions for how he/she can improve this?

73. Strengths
    
    
    
74. Areas for Development
    
    
    
75. Please give any final comments or suggestions for [Participant Name Here]'s assessment.